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Federal forms, ICRs, and supporting documents

Information Collection

ATSDR Health Education Activity Tracking (HEAT) Form

IC 226334 under ICR 202309-0923-001 · OMB 0923-0057.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-WORD document to display instr
Other-WORD document to display instr
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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ATSDR Health Education Activity Tracking (HEAT) Form
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Health Education (screenshots) Att4a ATSDR HE Form (ARMSS Screenshost) 08212023.pdf Yes Yes Fillable Fileable
Other-WORD document to display instrument content Att4a1 ATSDR HE Form ( WORD) 08212023.docx No   Paper Only

Health Consumer Health and Safety

 

30 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 510 0 -526 0 0 1,036
Annual IC Time Burden (Hours) 34 0 -18 0 0 52
Annual IC Cost Burden (Dollars) 0 0 -1,932 0 0 1,932

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.